Kornimate/medical-research-clean huggingface dataset:
heart rate variability for prediction of perioperative events

Conditions: Anesthesia; Coronary Heart Disease

Summary: patients with underlying cardiovascular disease are at high risk of perioperative cardiovascular events and death. hemodynamic variables are controlled by the autonomic nervous system reflected by heart rate variability. to investigate whether differences of hrv parameters predict perioperative cardiovascular events.

hypotension and bradycardia following induction of anesthesia may result in insufficient organ perfusion. patients with underlying cardiovascular disease are at high risk of perioperative cardiovascular events and death. hemodynamic variables are controlled by the autonomic nervous system reflected by heart rate variability (hrv). several authors demonstrated depressed long-term hrv in patients with underlying cardiovascular disease. depressed 24 hours hrv proved to be highly predictive for cardiovascular morbidity and mortality recently, short-term analysis was demonstrated to be a reliable tool to predict hypotension after spinal anesthesia. no data are available, however, with respect to preoperative hrv values and incidence of postoperative cardiovascular events. to investigate the prognostic value of hrv in patients with underlying cardiovascular disease. hypothesise i) differences in pre-operative hrv are present in patients with underlying cardiovascular disease, ii) depressed preoperative hrv indicates high risk of post-operative cardiac ischemia, iii) depressed preoperative hrv is associated with longer postoperative hospital stay and adverse cardiac events after hospital discharge. first, patients are assigned to one of two groups depending on the presence or absence of postoperative cardiac ischemia; second, a predictive model will be built to confirm our findings prospectively in another group of patients. patients: 100 patients (asa physical status class ii - iv) scheduled for general anesthesia. inclusion criteria:evidence of high perioperative cardiovascular risk based on the revised cardiac risk index (rcri \>3).exclusion criteria: lack of sinus rhythm, emergency cases, postoperative admission to an intensive care unit and age under 18 years. time and frequency domain parameters of hrv will be recorded at the day of surgery before induction of anesthesia. cardiovascular events and outcome will be analyzed.

Eligibility criteria:
inclusion criteria: * patients with cardiovascular risk factors defined as revised cardiac risk index score \<= 3 scheduled for general anesthesia exclusion criteria: * lack of sinus rhythm, emergency cases, age \< 18 years

Keywords: anesthesia, general abnormalities, cardiovascular heart rate forecasting
antigen presentation and lymphocyte response in parkinson's disease

Conditions: Parkinson's Disease

Summary: the way the immune system responds to certain pd-related proteins in pd donors compared to the way it responds in persons without or fewer pd related proteins is not well studied and this study aims to analyze the autoimmune response in each group. the study involves a one time visit involving brief questionnaires and a blood draw of 30 ml (approximately 2 tablespoons) to be collected.

the role of the immune response in parkinson's disease (pd) is controversial. recent studies show that neurons can present mhc-i (major histocompatibility complex - class 1) molecules and therefore may be susceptible to an attack by immune cells. the investigators anticipate that the results of this study will improve our understanding of the mechanisms of immune mediated neuronal degeneration in pd. initial results suggest that antigens are presented by neuronal mhc-i in pd, and that this could lead to t-cell mediated neuronal death. the most obvious antigen that could be differentially expressed in pd patients and controls would be alpha-synuclein (-syn): -syn oligomers appear in all lewy bodies and lewy neurites and are the hallmark of pd changes in the brain. this study will offer the opportunity to further characterize the immune mediated component of pd, and to continue elucidating the biology that underlies antigen presentation and t-cell cytolytic activity.

Eligibility criteria:
inclusion criteria: * moderate to advanced pd with classic motor features, and must demonstrate two of the following three: rest tremor, rigidity, or bradykinesia * dopaminergic medication benefit (self-reported improvement) * age at recruitment: 50 - 90 years * age at diagnosis \> 47 * pd duration \> 3 years * willingness to have genotyping and genetic studies as part of laboratory research exclusion criteria: * atypical parkinsonism or other neurological disorders * recent history of cancer (past 3 years) * autoimmune disease (except thyroid disease) * on chronic immune-modulatory therapy (e.g. sit (specific immunotherapy), anti-ige) * inability to provide informed consent

Keywords: parkinson's disease autoimmunity
chewing gum effect in reducing orthodontic pain after separator and initial arch wire placement

Conditions: Orthodontic Pain

Summary: pain is the most claimed complaint from orthodontic treatment. fear of pain has contributed to patients' avoidance of seeking orthodontic treatment, affects patients' compliance to treatment and even becomes the main reason for discontinuing orthodontic treatment. for years, orthodontic patients have reported using analgesics during orthodontic treatment to ease the pain. however, analgesics have many side effects such as allergic reactions, bleeding disorders, gastric ulcers, liver toxicity and their potential influence in slowing down tooth movement. this study aimed to investigate the effectiveness of chewing gums in pain reduction in malaysian multi-ethnic orthodontic patients and to explore the possibility of chewing gum to be recommended as a suitable substitute for analgesics in our future practice.

orthodontic treatment have been shown to cause varying degrees of discomforts and pain to the patients. fear of pain has contributed to patients' avoidance of seeking orthodontic treatment, affect patients' compliance to the treatment and even become a main reason of discontinuing orthodontic treatment. patients have reported using of analgesic particularly nsaids and paracetamol during orthodontic treatment to ease the pain. however, nsaids have been associated with various side effects such as allergic reactions, bleeding disorders and gastric ulcers had raised the concern of orthodontists. studies on animals have shown that nsaids slower the rate of tooth movement, hence affecting orthodontic treatment efficacy. paracetamol have been reported to cause liver toxicity in the case of over dosage. the action of chewing the gum can produce forces to temporary displace the teeth sufficiently to allow blood flow through compressed area, preventing the build-up of metabolic products, thus reduce the pain severity. in addition, non-sugared chewing gum has anti-caries effect which is very important to prevent caries formation during orthodontic treatment. this study aimed to investigate the effectiveness of chewing gum in pain reduction in orthodontic patients and to explore the possibility of chewing gum to be recommended as a suitable substitute for analgesics in future practice.

Eligibility criteria:
inclusion criteria: 1. patients about to undergo orthodontic treatment with maxillary and mandibular fixed appliances 2. orthodontic treatment include the extraction of the permanent first or second premolars 3. age 16 years and above exclusion criteria: 1. significant medical problem or cleft lip and palate. 2. pregnant lady 3. occurrence of using analgesics or antibiotics 4. history of asthma or unstable asthma the last year 5. oral surgery in the previous 4 weeks

Keywords: chewing gum, orthodontic pain
filgotinib effect on proteomic profile and micro-rna expression in patients with active rheumatoid arthritis (ra)

Conditions: Rheumatoid Arthritis

Summary: purpose: the study aims to investigate how filgotinib affects proteins and micro-rna in the blood of patients with rheumatoid arthritis. this could help understand its impact on inflammation and bone health in these patients. study design: this is a single-center, prospective randomized study.

population: the study will include 30 patients with active rheumatoid arthritis: 15 patients treated with filgotinib. 15 patients treated with adalimumab (used as a comparison group). procedures: participants will have blood samples taken at the start and then every 4 weeks up to 12 weeks. these samples will be used to analyze changes in proteins and micro-rna. participants will continue their regular rheumatoid arthritis treatment during the study. primary objective: to observe changes in the metabolic profile (proteins and micro-rna) in patients treated with filgotinib. secondary objectives: compare the metabolic profile changes between filgotinib and adalimumab. identify metabolic factors associated with early clinical response to filgotinib. safety and data management: adverse events will be monitored and reported. patient confidentiality will be maintained according to privacy laws. study duration: recruitment: 16 weeks. patient involvement: 12 weeks. total study duration: 28 weeks.

Eligibility criteria:
inclusion criteria * rheumatoid arthritis (ra) according to acr/eular 2010 criteria with active disease (disease activity score 28-joints c-reactive protein \[das28 crp\] \>5.1 and/or clinical disease activity index \[cdai\] \>22) * age \> 18, \<65 years * patients for whom treatment with filgotinib or adalimumab might be planned exclusion criteria * history of major cardiovascular events or stroke * history of venous thromboembolism * active smokers or past smokers \>10 pack/years * history of fragility fractures or severe osteoporosis (t score at total hip or femoral neck or lumbar spine ≤3.5) * treatment with bone-active medications (estrogens, bisphosphonates, denosumab, teriparatide, romosozumab) * chronic treatment with moderate to high dose of glucocorticoids (≥7.5 mg/day of prednisone equivalent for more than 3 months prior to enrollment), short term (\<3 months) will be accepted if tapered, as clinically feasible, to \<7.5 mg/day before enrollment)

Keywords: ra
assessment of vital pulp therapy in permanent molars

Conditions: Dental Caries Extending to Pulp; Pulp Disease, Dental

Summary: the purpose of this study is to evaluate the long term clinical performance of vital pulp therapy of young permanent teeth with irreversible pulpitis

permanent molar teeth meeting the inclusion criteria will be included into the study. following local anaesthesia and dental dam application, caries excavation will be performed; and after exposure, the pulp will be amputated to the level of the canal orifices (full pulpotomy) using a sterile high-speed round bur under water coolant. after haemostasis is achieved, mineral trioxide aggregate (mta) will be gently placed over the pulp to a thickness of 2-3 mm and the tooth will be restored using glass ionomer cement and composite resin. a postoperative periapical radiograph will be taken. patients will be reviewed at 6., 12., 24. and 36. months for clinical and radiographical success. the data will be analysed statistically using chi square test.

Eligibility criteria:
inclusion criteria: * patients and parents of the patients who accept to participate and sign the informed consent * patients who have at least one vital permanent molar teeth with irreversible pulpitis symptoms * teeth which can be restorable after the treatment. * teeth which has good periodontal health and in the absence of sinus tracts or swelling. exclusion criteria: * patients and parents of the patients who does not accept to participate and sign the informed consent * teeth which have dentoalveolar or extraoral swelling * teeth which have periodontal disease, mobility or alveolar bone loss * teeth which are not restorable * patients who are not cooperative with the treatment

Keywords: permanent teeth vital pulp therapy mta
sit-to-stand training with interactive feedback in chronic stroke

Conditions: Stroke

Summary: the major problems of people with chronic stroke include muscle weakness, sensory alteration, and inter-muscular coordination impairment. inter-muscular coordination impairment caused altered muscle contraction sequences and weight-bearing asymmetry during functional activities. sit-to-stand (sts) training is often used to improve functional activities among post-stroke subjects. however, the improvement may come from compensatory movements. using compensatory movement may cause muscle weakness in the affected side and increase fall risk. this study will develop a novel sts training system with interactive visual and audio feedback emphasizing weight transferring and weight bearing. the present study aims to investigate the effects of sit-to-stand training with interactive visual and audio feedback on muscle contraction sequences and weight bearing symmetry in individuals with chronic stroke.

this is a prospective randomized single-blinded controlled trial with pre- and post-measurements. 20 individuals will be recruited, and randomly assigned to experimental or control group. statistical data analysis will be done by spss 24.0. baseline characteristics will be analyzed using independent t-test or chi-square test. repeated measures two-way analysis of variance (anova) with tukey's post-hoc analysis will be used for time-by-group comparisons. the significant level is set at 0.05.

Eligibility criteria:
inclusion criteria: * diagnosis of stroke ≥ 6 months * mini-mental state examination (mmse) ≥ 24 points * brunnstrom lower limb recovery stage: ≥ stage 3 * be able to independently perform sts for at least 10 times * single sts \>1.7 seconds * be able to walk ≥10 meters independently exclusion criteria: * any other musculoskeletal, neurological and cardiovascular diseases * have visual or language impairments

Keywords: interactive feedback muscle contraction sequence weight bearing symmetry sit-to-stand training chronic stroke
preoperative dexamethasone to improve quality of recovery after laparoscopic bariatric surgery

Conditions: Anesthesia; Analgesia; Acute Pain

Summary: in the obese patient, adequate pain relief in the postoperative period is an important parameter that affects patient comfort and hospital stay. increasing patient comfort and recovery quality can be achieved by avoiding undesirable effects such as nausea and vomiting, as well as analgesia. in our study, our aim is to evaluate the effect of dexamethasone added to multimodal analgesia on postoperative patient comfort in the obese patient group with a 40-item scale.

postoperative pain prolongs hospital stay, delays wound healing, increases infection rates, and increases the incidence of drug side effects due to the use of systemic pain relievers (especially opioids). good pain control facilitates respiratory effort, allows the patient to perform respiratory exercises and cough to correct the increased thoracic fat mass and impaired respiratory mechanics due to anesthesia. the patient without pain is mobilized early and discharged early. our aim is to evaluate the effect of dexamethasone added to multimodal analgesia on postoperative patient comfort in the obese patient group with a 40-item scale. patients will be divided in to two groups (group d and group c): group d (dexamethasone group): patients who used/applied dexamethasone before bariatric surgery were included in this group. group c(control group): patients who did not use dexamethasone or steroid-derived drugs were included in this group. the patients included in the study were evaluated with the 40-item recovery quality scale (qor-40) 24 hours after the operation. i̇n addition all patients will be administered iv morphine pca (patient controlled analgesia) for the first 24 hours postoperatively

Eligibility criteria:
inclusion criteria: * body mass index\>30 kg/m2 * the american society of anaesthesiologists (asa) physical status class i, ii * the american society of anaesthesiologists (asa) physical status class iii only because of morbid obesity * patients who will undergo an elective laparoscopic sleeve gastrectomy (lsg) * those who are literate enough to answer the compilation quality score (qor-40) questionnaire exclusion criteria: * refusal to participate * allergy to the study drugs * chronic kidney disease (creatinine\>150 μmol/l) * mental illness * liver, respiratory or oncological disease, * cardiac dysfunction (ejection fraction \<40%), * uncontrolled hypertension, * preoperative analgesic use, * chronic pain, * history of alcohol or drug addiction

Keywords: dexamethasone quality of recovery-40 acute pain scores morphine consumption
safety and efficacy of nonsteroidal antiinflammatory (nsai)drug and glucocorticoids in acute sciatica

Conditions: Sciatica

Summary: the purpose of this study is to determine whether anti-inflammatory drugs or glucocorticoids are effective in the treatment of acute sciatica


Eligibility criteria:
inclusion criteria: * sciatica \<8 weeks resistant to all treatments in ambulatory * acute low back pain\> 48 hours; * non-deficit patients; * initial vas\> 40/100; * consent of patient * conflict disco-radicular concordance with the clinical computed tomography scan or magnetic resonance imaging. * no of contraindications to methylprednisolone, ketoprofen; * no registration to another protocol; exclusion criteria: * pregnant, parturient, lactating mother; * diabetic patient; * patient with syndrome from narrowing of the lumbar vertebral canal * patient with a history of lumbar surgery \<1 year; * patient with a cauda equina syndrome or major motor disability; * crural neuralgia * patient with a deficit; * suspicion of sciatica secondary, ie not conflict-related disco-root: infectious neuritis, fracture on spinal bone tumor ... associated treatment or pathology contra-indicating administration methylprednisolone, ketoprofen.

Keywords: sciatica anti-inflammatory agents, non-steroidal glucocorticoids
esophageal temperature management during cryo af ablation (ensoetm)

Conditions: Atrial Fibrillation

Summary: the purpose of this pilot study is to determine if esophageal warming using the attune medical esophageal heat transfer device (ensoetm) limits the frequency or severity of thermal injury during cryoballoon ablation of atrial fibrillation.

catheter ablation of atrial fibrillation (af) has become a common ablation procedure performed worldwide. the cornerstone of this procedure is pulmonary vein isolation (pvi). pvi can be achieved by multiple methods, the two most common being radiofrequency (rf) and cryoablation. energy delivery may extend beyond the atrial myocardium and result in damage to adjacent structures, including the esophagus. atrio-esophageal fistula (aef) is a rare, but a well-recognized complication of percutaneous af ablation. the occurrence rate of esophageal injury has varied depending on the reporting center, timing of endoscopy, and the ablation technique utilized. esophageal ulceration is likely the initial injury that leads to aef formation and is probably present within hours to days of the ablation procedure. the attune medical esophageal heat transfer device (ensoetm) is a non-sterile, multi-lumen silicone tube placed in the esophagus for the purpose of cooling or warming a patient while simultaneously allowing gastric decompression and drainage. for this study, the ensoetm tube will be used during cardiac ablation procedures for the intended indication of patient temperature management using approved settings/parameters as detailed in the product instructions for use document. ensoetm is an fda approved device. this prospective, randomized study will include 40 patients with symptomatic af undergoing index pvi under general anesthesia at northwestern memorial hospital. patients will be randomized in a 1:1 fashion with 20 patients (group a) randomized to undergo the ablation procedure with esophageal warming and the other 20 patients (group b) will serve as the control group and will not have the ensoetm device used. all patients will undergo esophagogastroduodenoscopy (egd) 1-2 days following the ablation procedure to evaluate for esophageal injury.

Eligibility criteria:
inclusion criteria: 1. patients above the age of 18 years old. 2. patients with the diagnosis of atrial fibrillation undergoing clinically indicated de-novo af ablation procedure. 3. patients must be willing to provide informed consent. exclusion criteria: 1. patients with contraindication to egd. 2. history of prior af ablation procedures. 3. significant co-morbidities that preclude standard ablation procedure. 4. patient is ineligible for ensoetm placement due to: * known esophageal deformity or evidence of esophageal trauma (for example history of esophagectomy, previous swallowing disorders, achalasia). * known ingestion of acidic or caustic poisons within the prior 24 hours. * patients with \<40 kg of body mass.
expanded access study for the treatment of patients with commercially out-of-specification brexucabtagene autoleucel

Conditions: Mantle Cell Lymphoma; Acute Lymphoblastic Leukemia

Summary: the goal of this study is to provide access to brexucabtagene autoleucel for patients diagnosed with a disease approved for treatment with brexucabtagene autoleucel, that is otherwise out of specification for commercial release.


Eligibility criteria:
inclusion criteria: * have commercially manufactured brexucabtagene autoleucel that does not meet commercial release criteria but does meet kite clinical trial release criteria * females of childbearing potential must have a negative serum or urine pregnancy test (females who have undergone surgical sterilization or who have been post-menopausal for at least 2 years are not considered to be of childbearing potential) * deemed medically fit and stable to receive the product per the investigator's evaluation * repeat leukapheresis is not feasible per the investigator's assessment * be diagnosed with 1 of the approved labeled indications for brexucabtagene autoleucel that is intended for release * in the investigator's opinion, there is no satisfactory alternative therapy available to the individual exclusion criteria: * history of severe immediate hypersensitivity to any drugs or metabolites of similar chemical classes as brexucabtagene autoleucel * uncontrolled active infection or inflammation per physician assessment * primary central nervous system (cns) lymphoma